title: Energy density, diet quality, and central body fat in a nationwide survey of young Spaniards.
abstract: OBJECTIVE
  To determine the impact of energy density on diet quality and anthropometric proxy measures for central body fat in young Spaniards.
  
  
  METHODS
  Data were obtained from a representative national sample of 2513 young Spaniards aged 10 to 24 y. Dietary assessment was performed with a 24-h recall. Adherence to the Mediterranean diet was measured by the KIDMED index. Reduced rank regression analysis was used to identify energy-density dietary patterns. Waist circumferences and height were measured.
  
  
  RESULTS
  Pastries and sausages showed the strongest loading for the dietary energy density factor score (DED-FS), with fruits and vegetables at the opposite end of the scale. Multiple linear regression analysis showed a positive association (P < 0.01) of dietary energy density (DED) and the DED-FS with waist circumferences regressed on height and age (WCheight+age) and waist-to-height ratio (WHtR). The adjusted odds ratio for elevated WCheight+age and WHtR increased across quartile distribution of DED (P < 0.001) and DED-FS (P < 0.05). Diet quality characterized by the KIDMED index was negatively associated (P < 0.001) with DED and the DED-FS.
  
  
  CONCLUSIONS
  Higher DED is a risk for increased central fat distribution and is associated with low adherence to the Mediterranean diet.
authors.affiliation: Cardiovascular Risk and Nutrition Research Group (CARIN), Research Programme in Inflammatory and Cardiovascular Disorders (RICAD), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain. Electronic address: hschroeder@imim.es.
authors.forename: Helmut
authors.initials: H
authors.lastname: Schröder
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mendez
authors.forename: Santiago F
authors.initials: SF
authors.lastname: Gomez
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fíto
authors.forename: Lourdes
authors.initials: L
authors.lastname: Ribas
authors.forename: Javier
authors.initials: J
authors.lastname: Aranceta
authors.forename: Lluis
authors.initials: L
authors.lastname: Serra-Majem
mesh_terms: D000273:Adipose Tissue; D050154:Adiposity; D000293:Adolescent; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D063427:Food Quality; D005638:Fruit; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009043:Motor Activity; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D016017:Odds Ratio; D013030:Spain; D011795:Surveys and Questionnaires; D014675:Vegetables; D055105:Waist Circumference; D055815:Young Adult
keywords: Diet quality; Energy density; Mediterranean diet; Waist circumferences; Waist-to-height ratio